Infertility: Treatment, Procedure, Cost and Side Effects

For most women, the ultimate feeling is bringing their bundle of joy into this world. However, as much as you want, getting pregnant is not always in your hand. Infertility among women has seen an exponential growth in the last decade or so. In this article, we will limit our discussion to the factors responsible for female infertility.

In many women of reproductive age, PCOS (Polycystic Ovarian Syndrome) is found to be one of the common underlying factors making it difficult for the affected female to conceive. PCOS, as indicative of the name, is a condition whereby cyst formation takes place in the ovary or the ovaries. PCOS triggers a hormonal imbalance with increased production of androgen by the ovary interfering with the ovulation process. The mature eggs either don't get released from the ovary or in some cases, the eggs may not mature at all. Infertility can be one of the many depressing complications associated with the disorder.

Primary Ovarian Insufficiency can also be responsible for female infertility. True to its name, the disorder is an autoimmune condition resulting in the loss of eggs prematurely (from the ovary). The condition can be a genetic predisposition or at times may be a consequence of chemotherapy.

The hormones Follicle Stimulating Hormone (FSH) and Luteinizing hormone (LH) play a pivotal role in ensuring a healthy ovulation process. However, certain factors including obesity, drastic changes in the body weight (gain or loss) or stress (physical, mental, or emotional) can spell doom inhibiting the production of FSH and LH. In the absence of these two hormones, the ovulation process will also be affected, often giving rise to female infertility. The increased production of another hormone, Prolactin can also act as the trigger resulting in infertility. Proper treatment and medications can go a long way to reverse the condition.

Under certain conditions, the tissues that are supposed to line the inside of the uterus (a term called endometrium) grows outside it (often in the fallopian tubes, or ovaries) a condition termed as Endometriosis. While the painful condition in itself can lead to female infertility (can damage the implanted fertilized egg), removing the tissues through surgery can also damage the fallopian tube. With a damaged fallopian tube, infertility is the obvious consequence.

Certain medical conditions such as pelvic tuberculosis, STDs that triggers inflammation and infection of the fallopian tube and the uterus, women having undergone surgery for ectopic pregnancy, or the inflammatory diseases of the pelvis can also damage the fallopian tube

Infertility in females can also be an outcome

• Cervical stenosis (the cervix narrows down to a great extent).
• Congenital uterine disorders and abnormalities.
• The formation of noncancerous tumors and polyps in the uterus can trigger infertility in some females only.
• In some rare cases, the exact cause of infertility may be hard to explain (Unexplained Infertility).

In case you have a concern or query you can always consult an expert & get answers to your questions!

What is In vitro fertilization?

In vitro fertilization (IVF) is a process of fertilization where an egg is combined with sperm outside the body. This involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (eggs) from the woman's ovaries and then letting sperm fertilize them in a liquid in a laboratory. The fertilized egg (zygote) undergoes embryo culture for 2–6 days.It is then transferred to the same or another woman's uterus, with the intention of establishing a successful pregnancy.

What is the success rate of it?

The success rate depends on factors such as, maternal age, cause of infertility, embryo status, reproductive history and lifestyle factors.

1. Maternal age: Younger candidates of IVF are more likely to get pregnant. Women older than 41 are more likely to get pregnant with a donor egg.
2. Reproductive history: Women who have been previously pregnant are in many cases more successful with IVF treatments than those who have never been pregnant.

How is it a Blessing?

1. Chemotherapy: IVF allows women who are being treated for cancer with chemotherapy to be able to have children. Chemotherapy can destroy or damage the eggs within the ovary. Prior to undergoing chemotherapy treatment, some women may elect to have eggs harvested, frozen, and saved for possible subsequent attempts to have a child after the cancer treatment is completed.
2. Absent Uterus: IVF treatment can allow a woman to have a child if she does not have a uterus. The eggs must be harvested from the patient’s ovaries and are then placed inside another woman’s uterus.
3. Low Sperm Count: When sperms are defective or counts are extremely low, IVF can be used to become pregnant. IVF can work for these conditions because sperm is  placed directly next to the egg, and, in some cases, sperm is injected into the egg (ICSI) to allow the pregnancy to occur.
4. Absent Ovaries: IVF can be used for a woman without ovaries. The eggs must be donated from another woman.
5. Older Age: IVF can be used for women over the age of 42 to become pregnant. To obtain this reproductive advantage, donated eggs (eggs from another woman younger than 30) must be used
6. Unexplained Infertility: Some couples do not have a diagnosed reason for their infertility. This is called unexplained infertility. IVF allows egg and sperm to join together outside of the woman’s body.
7. Severe Tubal Disease: Some women have extensively damaged fallopian tubes from pelvic inflammatory disease (PID) or from severe intra-abdominal infections. IVF is designed to bypass the tubes by allowing conception to occur outside the body.The fertilized eggs are then introduced into the uterus in the hope of pregnancy.

In case you have a concern or query you can always consult an expert & get answers to your questions!

PCOS tops the list of reasons for female infertility. A few women manage to conceive with PCOS but the pregnancy could be full of complications. Chances of miscarriages even during the 28th week are possible if a woman suffers from PCOS. This is also called as PCOD, which is an endocrine disorder. In this condition, the hormone levels are imbalanced and inflammation also occurs. This results in disruption of ovulation, and getting pregnant becomes a Herculean task. PCOS is not only the reason for infertility but also results in other discomforting symptoms such as weight gain, acne, hair fall, and skin darkening.

Ovulation problems in PCOS: PCOS results in anovulation, which is the lack of ovulation or irregular ovulation. This can be due to various reasons. Estrogen is not produced adequately by the ovaries, hypothalamus does now secrete the gonadotropin-releasing hormone, and there is hypothyroidism or the excess of testosterone in the adrenal glands. PCOS can occur due to various reasons ranging from wrong food habits, inadequate sleep, fatty liver, negative thoughts, stress, no detoxification, poor fat metabolism, and genetic reasons. Women who have mother or sister suffering from PCOS have an increased risk of being affected by this disorder. Women who have excess insulin in their body, too, can develop this disorder. Insulin resistance can trigger high blood sugar levels, and this means pancreas keeps producing more insulin. This can also lead to PCOS.

Managing PCOS: PCOS can affect fertility in multiple ways. The major problem is irregular ovulation. Ovulation may not occur because the follicles are not mature or when the woman has more testosterone. The hormonal imbalance does not let pregnancy happen even if there is ovulation. This is because the uterus is inefficient to develop the lining, which is vital for implantation to occur. The menstrual cycle is irregular, and it is unpredicted. PCOS can only be managed but the good news is that one can increase the chances of fertility with medications. The symptoms vary from woman to woman, so doctors give treatment options to suit the specific requirements. The hormonal imbalance is corrected with birth control pills. But if you are looking forward to a child, these pills should be the last thing you need. The doctor comes up with other options in such cases.

Medications: PCOS also needs medication to control the blood sugar levels. Often, one can see the dietary changes are recommended when getting treated for PCOS. An exercise routine is emphasized and such women also advised to maintain a healthy weight. This is to ensure that the insulin levels and the testosterone levels are under control. Medications to regulate the menstrual cycle is also prescribed to women who want to improve their fertility and chances of conception. Based on the scenario, a surgery may be on the cards. Laparoscopic ovarian drilling is a procedure performed by a team of medical professionals to treat PCOD.
Chances are there that PCOS isn’t the only reason for you to not get pregnant. So, a complete checkup to diagnose and analyze the problems for infertility is done by the doctor. You may need a combination of medications so that your chances of becoming a mother are heightened.

In case you have a concern or query you can always consult an expert & get answers to your questions!

A number of different factors can cause the problem of infertility in women. The issue of infertility is not new to the medical world. Various medications and treatments have come up with the advancement of science and this has helped cure the problem of infertility over time. Although infertility can have a severe impact on your mental health, it is still not impossible to cure. There are multiple medications and treatments which can still give you a healthy chance of having a baby. Age is one of the major factors which cause the problem of infertility in women as women are born with a finite number of eggs and with increasing age, the number of eggs automatically reduce. Therefore, to avoid infertility, opting for an early pregnancy can also be suggested.

Start With a Thorough Diagnosis
A number of blood tests are carried out to determine the cause of infertility, like the presence of cystic ovaries, abnormal hormonal levels or any other cervical problem. Apart from that, the procedure of Laparoscopy is also carried out to look at the outer lines of the fallopian tube, ovaries, and uterus as well. This procedure helps the doctors in identifying any abnormal growth in the pelvic region. The next procedure which is carried out is HSG or Hysterosalpingography which involves the insertion of a dye or a saline into the cervix through ultrasound or X-ray to check for any kind of blockage in the fallopian tube.

Various Treatments for the Problem of Infertility

1. IVF or In Vito Fertilization is the most advanced procedure which is used to help the sperms and eggs. This artificial technique of fusing the sperms and the eggs outside the body and placing it in the uterus after the formation of the embryo is one of the most used procedures in the case of infertility.
2. Another alternative treatment which can be chosen is the Assisted Reproductive Technology. Hormonal therapy along with the combination of fertility drugs are two procedures which are used in this technology. Other types of tests which are carried out are intrauterine insemination and zygote intra fallopian transfer among others.
3. Egg donation is another popular method which is used during infertility. This process involves the removal of Oocytes from the ovary of women who have taken fertility drugs.
4. A small amount of concentrated sperm cells is used in another method called Intrauterine
5. Insemination which only requires a few minutes to be completed and is an extremely painless process.

Along with these other alternative methods of surrogacy, ZIFT or Zygote Intrafallopian Transfer and special medical therapies can also be used to increase the fertility rate.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Male factor infertility is a common problem these days and it describes those couples that have failed to be pregnant owing to health issues of the male partner. While in most cases, people have a general misconception that infertility is related to female reproductive issues only, recent statistics say otherwise.

Various reasons can be attributed to male infertility which may range from low production of sperm to poor quality sperms, to abnormal morphology. Male factor infertility is also related to men who have normal sperm production, but it does not get transported to the vagina during intercourse.

Evaluating male factor infertility-

It is crucial to evaluate men who are suspected to be infertile through comprehensive checkups, physical tests, and numerous semen analysis. In certain conditions, additional tests and evaluations may also be required. For men with a severely low production of sperms, and poor sperm motility, it is important to consider karyotypic abnormalities. Male factor infertility was previously regarded as a contraindication to in-vitro fertilization since the presence of abnormal sperms may not be able to fertilize female eggs. But recent statistics show that there is an indication of IVF allowing fertilization and eventual live births in couples where the man has impaired sperms. IVF has shown commendable success in the treatment of such men.

When to consider IVF?
It goes without saying that IVF has benefitted many couples suffering from male factor infertility over a decade. Some of the most common problems treated by IVF include:

1. Men having poor quality semen which may involve poor motility, low concentration and even poor morphology dealing with the shape of the sperm.
2. Couples who have failed to conceive through normal intercourse and conventional infertility treatments.
3. Men with non-obstructive and poor quality sperms can also benefit from the IVF process. Generally, such men produce sperm in a reduced quantity and also have an absence of sperm in their ejaculate. Some men who have undergone chemotherapy may also have compromised sperm quality as well as quantity.
4. Men suffering from the congenital bilateral absence of the vas deferens or CBAVD are able to produce sperm but they do not have the vas deferens which is the outflow tract.
5. Lastly, men who have undergone vasectomies and did not wish to undergo a reversal can obtain sperm that can be used in the IVF process.

Regardless of what’s causing infertility, it is important to consult an IVF expert to get through the process. IVF with the help of intracytoplasmic sperm injection is an advanced laboratory process in which a healthy sperm is injected into an egg for creating an embryo which is subsequently implanted into the uterus of the women. Besides the IVF treatment, medications and hormone therapy may also be used for altering high or low hormone level affecting fertility.

In case you have a concern or query you can always consult an expert & get answers to your questions!